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 SMTP is NOT captured / centealized. It can be installed where ever you want like a Nostr relay. 
 Except your client does not live in a bubble. It needs to communicate and send emails to other clients.

In order to combat spam, many popular email providers rank messages using an array of criteria, coming from a known and well publicised email provider is one such criteria and not coming from a well known provider is one such criteria that redirects your email to many people's spam folders.

So the question remains, how do we ensure that nostr relays don't start to use exclusionary metrics to avoid spam and abuse? 
 Nostr has many issues with the decentealizatuon concept. And if we are honest Nostr is already some kind of centralized as we have not thousands of relays. You can solve the issue with spam with paid relays but then the whole concept is senseless 
 Yeah, I think relays need an incentive model to share data with one-another. That way if you want to switch to another relay, you can without worrying about data loss.

Assuming you are paying for spam filtering and content quality and not for "hosting". 
 And here comes the big problem with privacy into the game 
 https://blog.lopp.net/death-of-decentralized-email/ 
 I know this article but still you can install your own SMTP and use it 
 I'm familiar with this article. I run my own email servers for more than a decade on both VPS and physical servers. If you want 99.99% deliverability you have to give up self sovereignty and stick with gmail. If you're ok with 99% deliverability and not sending spam aka "newletters" then self hosting is fine. Good workaround is to use individual websites contact forms when sending an initial inquiry/request then the followups are easier. 
 You can install it but it's a mission to maintain and ensure other large centralised providers accept your email (gmail and outlook). 
 It mostly depends on your IP reputation.  
 🎯 
 it's just a SPF record in your DNS...